Ressenti des femmes après traitement prophylactique par héparine de bas poids moléculaire après une césarienne
Gynécologie Obstétrique Fertilité & Sénologie , ISSN: 2468-7189, Vol: 52, Issue: 9, Page: 505-510
2024
- 2Captures
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Metrics Details
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Article Description
Évaluer le ressenti de femmes ayant eu une césarienne sur leur ressenti des effets secondaires cutanés liés aux injections d’HBPM par voie sous-cutanée après une césarienne et analyser leur impact sur la compliance au traitement. Un questionnaire a été élaboré avec l’association Césarine explorant les modalités de réalisation de la prévention thromboembolique par injection sous-cutanée d’héparine de bas poids moléculaire (HBPM), les effets secondaires cutanés, la compliance, la contrainte, l’appréhension et la compréhension du bénéfice du traitement. L’opinion des femmes sur une approche alternative par voie orale était questionnée en tenant compte de la contre-indication en cas d’allaitement. Le questionnaire était sur la page Facebook® et le blog de l’association. Cent soixante-quatre femmes ont répondu. Cent trente-neuf femmes (84,8 %) rapportaient avoir eu des ecchymoses et 117 (71,3 %) un prurit, un érythème ou un nodule au point d’injection lors de l’utilisation d’HBPM. Un arrêt prématuré du traitement était retrouvé dans 36 cas (22 %), majoritairement, à l’initiative des femmes seules (77,8 %). Les raisons principales invoquées à cet arrêt prématuré étaient l’injection elle-même (71,4 %), les réactions cutanées (31,4 %), et le sentiment que le traitement était inutile (54,3 %). L’envie d’arrêter a été exprimé par 88 femmes (53,7 %) avec des raisons identiques à celles de l’arrêt prématuré. Trente-trois femmes (20,1 %) ont signalé des oublis. Pour une majorité des femmes, le traitement était vécu comme une contrainte et générait de l’appréhension. Une prise alternative par voie orale aurait intéressée 131 femmes (79,9 %). Seules 28 (17,8 %) l’auraient accepté si le médicament oral n’est pas compatible avec l’allaitement. Les effets cutanés de l’injection et les injections elles-mêmes impactent négativement la compliance du traitement par HBPM dans le post-partum après césarienne. Ces résultats suggèrent d’explorer des alternatives aux HBPM pour la prévention thromboembolique pour en améliorer la compliance ainsi que le confort des femmes. To assess women's experiences with skin-related side effects following subcutaneous low molecular weight heparin (LMWH) injections after a cesarean section, and to analyze their impact on treatment adherence. A questionnaire was developed in collaboration with Cesarine, a patients’ association, to explore various aspects of LMWH administration, including prevention methods, cutaneous side effects, treatment compliance, perceived constraints, apprehension, and understanding of treatment benefits. Additionally, women's opinions on an alternative oral administration approach were solicited, taking into consideration breastfeeding contraindication. The questionnaire was on the Facebook® page and blog of the association. One hundred and sixty-four women participated in the survey. Among them, 139 women (84.8%) reported bruising, while 117 (71.3%) reported pruritus, erythema, or nodules at the injection site. Treatment discontinuation was observed in 36 cases (22%), decided mostly by the women themselves (77.8%). The main reasons cited for discontinuation were discomfort during injection (71.4%), skin reactions (31.4%), and a perceived lack of effectiveness (54.3%). Furthermore, 88 women (53.7%) wanted to quit the treatment prematurely, citing similar reasons. Thirty-three women (20.1%) reported oversights. For most women, the treatment was perceived as burdensome and caused apprehension. An alternative oral administration method was of interest to 131 women (79.9%). However, only 28 (17.8%) would have accepted if the medication was incompatible with breastfeeding. Cutaneous side effects of LMWH injections, as well as injection process itself, have a negative impact on adherence in the postpartum period following a c-section. These findings highlight the need to explore alternative to improve women's compliance and comfort.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/S2468718924000837; http://dx.doi.org/10.1016/j.gofs.2024.02.027; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85188842722&origin=inward; http://www.ncbi.nlm.nih.gov/pubmed/38437947; https://linkinghub.elsevier.com/retrieve/pii/S2468718924000837
Elsevier BV
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